Could Homeopathy Hurt Haiti?

January 20th, 2010

Let’s get down to it. Haiti is the big story of the week, and I have a bit of a rant.

We could discuss the science of earthquakes, but we won’t. There is nothing we can do to stop earthquakes from ocurring. We could discuss the political issues at play. For instance, Pop. Mechanics reports that geologists warned the Haitian government that they were at extreme risk, and should take measures to reinforce response critical buildings like hospitals. Measures did not take place, and we see the aftermath. What I want to talk about is an interesting battle taking place on the field of disaster-response medicine that is based in science.

Doctors without Borders and the Red Cross are sending people by the hundreds to Haiti to respond to medical needs. They will be bringing with them scientifically proven treatments and supplies. And, they will need lots of supplies to treat all the wounded and sick. Interestingly, voices from the homeopathy camp are suggesting that Emergency Homeopathy kits and homeopaths should be sent to the frontlines to help. This is a very dangerous suggestion.

The successes that homeopathy boast seem to be based on the placebo effect – the fact that people think something is going to work seems to have a positive result – but, in all systematic reviews of the literature so far, it seems that which literature is included and why plays a major role in the study conclusions. Whether homeopathic treatments or placebos can be considered true protection or treatment is widely debated.

Simon Singh writes:

When critics point out to politicians or regulators that homeopathy is not backed by any good evidence and is just a placebo, one response is “What’s the harm?”. In other words, if the placebo effect is positive and the side effects are zero, then what’s wrong if people want to waste a bit of money on sugar pills? But is homeopathy really safe?

Unfortunately, homeopathy can have surprising and dangerous side-effects. These have nothing to do directly with any particular homeopathic remedy, but rather they are an indirect result of what happens when homeopaths replace doctors as sources of medical advice… For example, many homeopaths have a negative attitude towards immunization, so parents who are in regular contact with a homeopath may be less likely to immunize their child… Perhaps the greatest danger occurs when homeopathy replaces a conventional treatment…

… homeopaths failed to ask about the patient’s medical background and also failed to offer any general advice about bite prevention… homeopaths were willing to advise homeopathic protection against malaria instead of conventional treatment… [A] homeopath tried to explain the mechanism behind the remedies: ‘The remedies should lower your susceptibility; because what they do is they make it so your energy – your living energy – doesn’t have a kind of malaria-shaped hole in it. The malarial mosquitoes won’t come along and fill that in. The remedies sort it out.’

Science-based medicine brings up the concern that attitudes about vaccines could prove to be very detrimental to disaster scenarios.

One of the coming tragedies in Haiti will be widespread illness and death from vaccine-preventable diseases. A terrifying example is tetanus. Tetanus is a disease caused by the bacterium Clostridium tetani. These bacteria live in most soils, especially rich soils, and can easily infect small wounds. Once the infection takes hold, the bacteria produce a potent toxin responsible for most of the symptoms of the disease.  These symptoms include horrifying muscle spasms, including jaw spasms which give the disease its other name, “lock-jaw”. And it is a horrifying disease, affecting adults with even minor wounds, and babies, who can become infected at the site of their umbilical cord. The disease is frightening, causing uncontrollable muscle spasms resulting in death in nearly 100% of untreated cases. Even when treated, tetanus has a very high mortality rate, and given that tetanus tends to be more common in areas with less access to treatment, the impact is doubly felt. Neonatal tetanus is a dreadful disease, doubly so because it is so easily prevented. When mothers are vaccinated neonates are protected by passage of antibodies to the fetus in utero. Due mainly to political and economic conditions, tetanus vaccination rates in Haiti are low (about 50% in children). Previous similar disasters, such as the Kashmir earthquake and the Indian Ocean tsunami have showed us that tetanus is a special problem after natural disasters.

If anti-vaccination activists succeed in influencing the policies of the U.S. and other governments—as other fringe health activists have done—they may become morally complicit in the deaths of thousands of Haitians.

The bottom line here is: are we going to accept homeopathic and other unproven / unscientific remedies as part of medical disaster-response regimes when the lives of thousands are on the line?

If not there, then why accept them at all?

Think about it.

And, in the meantime, consider donating to the relief response in some way. Doctors without borders is one organization that can use some assistance. There are many ways to help that don’t directly involve money. It has come to my attention that airmiles can be transerred to other people, so if you have spare airmiles, they might help someone get to Haiti who can be of some help.

10 Responses to “Could Homeopathy Hurt Haiti?”

  1. Jason R on January 20, 2010 6:54 pm

    Thought this was an interesting case of direct protest against the homeopaths:

    “Boots hit by mass homeopathy ‘overdose’ – Hundreds of people are planning to ‘overdose’ on homeopathic remedies outside Boots stores to protest against the chemist selling treatments which critics say are ineffective.”

  2. Stephen on January 20, 2010 7:19 pm

    It seems to me that homeopathy would hurt Haitians by default – if people need medicine then just not giving them medicine if you otherwise could would hurt them.

    I suspect there’s a pretty remarkably placebo response to any care given out by aid workers after a natural disaster but ethically lying to people just after they’ve had an earthquake has got to be off the scale.

  3. Javier on January 20, 2010 7:36 pm

    Interestingly enough, I have just gotten back from my Latin American anthropology lecture about Haiti.

    I do agree that homeopathy is harmful and I wish it were not so prevalent, but there is a strong reason for its existence. Homeopathy is deeply ingrained in some places because many times it is a part of the people’s religion. In my experience, I was taught to accept and respect the beliefs of others. It seems homeopathy has leaked into this range of acceptance.

  4. DataJack on January 21, 2010 1:51 pm

    Great article, Dr. Kirsten, as usual.

  5. Mike on January 21, 2010 3:30 pm

    I just want to point out that Homeopathy has nothing to do with Religion.
    I think you are thinking more along the lines of Naturopathy.

    I think a lot of people have this confusion. Homeopathy is questionable. But Naturopathy can be just as effective as Pharmaceuticals; each have their own benefits and risks. (Pharmaceuticals are also patentable and therefore profitable while natural methods are not; and as you may or may not know, sadly this world revolves around money…for the moment anyways)

    But again it’s important to distinguish between Homeopathy and Naturopathy, they are two completely different things.

  6. David Emel on January 25, 2010 4:56 am

    Homeopathy is a responce to corrupt or inept medical practice. Due to it’s unregulated nature is bound to swarm with profiteers and snake oils. @Mike, Inventing a new definition does not make or guarentee a safe practice. The popularity of Homeopathy is a direct responce to expensive or ineffective Medical practice. Am I the only person who sees the conflict or interest with MBA and MDA? Treatments are sooooo much more profitable than cures.

  7. Mike D on January 30, 2010 3:50 am

    I was actually part of the mass-overdose protest in New Zealand, and while I think we made some sort of point, the media picked one telegenic homeopathy-user anecdote to counter us for ‘balance”. Also many of the comments on the TV story website were depressingly vitriolic and badly-infomed, but that’s to be expected I guess. The homeopath interviewed admitted the lactose pills has no actual active ingredient; it was all all done through electromagnetism. Sigh.

  8. bush on February 3, 2010 3:43 am

    I like how James “Amazing” Randy rants about homeopathy:

  9. Rod Miller on February 12, 2010 1:45 pm

    Dear Dr. Kiki:

    One question you forgot to ask on your removing the needle show…What causes autism? Perhaps vacinations or some other environmental factor cause mutations in men’s sperm The points made below apply to you too. How about a warped science show?

    Love All Your Shows!!!

    Rod Miller

    Seth and Molly:

    Below is my letter to Michael Specter. I have the same comment for Dr. Kiki when she pushes the same theme. The science denier theme seems easier for you do a show on then the corrupt or commercially skewed science that dominates theme. Do you think the Pharmaceutical industry does science on what is the most healthful treatment when it points away from their drugs? Do we need genetically engineered crops that allow greater use of herbicides when classes of plants and their dependents are exterminated from the local environments?

    Try a skewed science show for a change. Oops almost forget to say You have best science show in the universe!!!

    Thanks Rod Miller

    Dear Michael Specter:

    IMHO the flaw in your point of view is that you accept “science” as primarily a public good. What is science: the wrong hypothesis, current supported theories, the undeveloped theories, or the selective commercial theories of business? You say we should be skeptical of the science of the pharmaceutical interests/industry. The lovers of organic are precisely that. We are skeptical of commercial interests that have polluted the objectivity of not only science but also politics.

    Is cholesterol medication the best most healthful treatment for the target patients? Likely in the vast majority of cases no, particularly if you drink alcohol. The most healthful approach for these patients is likely dramatically changing diet. Where is the science to test my public interest theory? It is drowned by the weight of corporate interest. Have you made a political contribution today? Are you on any FDA review committees?

    Michael for those of us that have a choice we often choose to not give our money to the corrupt world even if the active science is only the placebo effect.

    Sincerely Obviously,

    Rod Miller

  10. Jeff Ericson on March 4, 2010 1:38 pm

    Dr. Kiki, I wholly agree with your main point – that homeopathic treatments are NOT what Haiti needs right now, and I think the powers-that-be are inclined to agree, from what I’ve seen.

    Your attack on homeothapy in general misses the point. Medicine does many things very well, including and especially dealing with traumas and infectious diseases. But there are significant weaknesses in the practice of medicine that complementary ‘care’ does much better than traditional western medicine:
    1. Medicine defines ‘health’ as a negative – the lack of disease or malady. Those of us fortunate enough to expect general good health (thanks largely to medicine) are realizing that a more comprehensive positive definition is useful – one that focuses on preventative care, longevity, wellness, etc. Whether or not the treatments are always effective, alternative medicines address this need, whereas conventional medicine, with the possible exception of Viagra-type drugs, plays no role whatsoever.
    2. Medicine treats bodies, or minds, but lacks the sophistocation to treat ‘people.’ Medicine is NOT science, it is the application of science, combined with personal experience, policy, and the pragmatics of business. Involving people in their own care somehow doesn’t fit into the clinical paradigm… you quote someone who says that the homeopath often doesn’t know the patient’s history – all the experience I have suggests the opposite – a 4 minute average interaction between a doctor and patient leads to mis-diagnoses and sub-optimal care in too many cases.
    3 Trust. Doctors have done a dismal job of maintaining the public trust. From allowing pharmaceuticals to hijack care (at least in perception) to failing to acknowledge the potential benefits of alternative care, to a general arrogance that has kept proven best practices like check-lists from mass adoption, people, especially young people, don’t trust the doctors, and this opens the door wide for anyone who can demonstrate a true interest in helping, and ideas (however faulty) for care.

    I love the show – keep up the great work of bringing interesting and diverse topics out to us, and for introducing us to interesting characters and role models for our children!


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